OPINION -- Telemedicine is picking up steam, growing exponentially and offering access to quality healthcare for patients wherever they are – in their homes, schools and workplaces – reaching out to remote rural areas as well urban areas. The cost is the same as, if not less expensive than care delivered in traditional settings, and we are seeing high rates of satisfaction from those who use it.
The growth of telemedicine has brought with it a host of changes. However, practice standards that are in place to protect patient care, as well as privacy and security measures for patient health information remain unchanged These changes have not come without concerns, and in some cases misunderstanding resulting in inaccurate information being shared. This is the case with the information presented in a guest opinion published in last week’s Lund Report.
The Telehealth Alliance of Oregon (TAO) would like to set the record straight about SB 144, a bill requiring the expansion of telemedicine reimbursement by private insurers.
Requiring health plans to cover telemedical health services was established by the Legislature in 2009 and included services provided between healthcare institutions such as hospitals and clinics. The purpose of SB 144 is to expand the requirements for health benefit plan coverage of telemedical health services by requiring them to provide coverage of telehealth services offered directly from a provider to a patient regardless of where they are. This includes homes, schools, and work places. Self-insured health plans offered through the Public Employees’ Benefit Board and the Oregon Educators’ Benefit Board are also included in the legislation.
Concerns were expressed that physicians licensed in Oregon will compete with doctors out-of-state. Any physician who practices in the state of Oregon must be licensed by the Oregon Medical Board. They can be fully licensed to practice in Oregon or obtain a telemedicine license. To obtain a telemedicine license, a physician must be fully licensed in one or more states and have no sanctions against him. This rule has been in place more than 10 years and to date, there have been no problems. If an out of state provider wants to practice in Oregon s/he can, provided s/he obtains a license. Oregon law requires that the a physician must be able to connect with the patient using two-way video (face to face) communication in order to receive reimbursement for the service. SB 144 does not change that.
Concern was also expressed that there are no standards for telemedicine to meet the HIPAA Security rule. All physicians are required to meet HIPAA privacy standards whether he/she practices telemedically or in person. Telemedicine is covered under the HIPAA security rule as well. HIPAA Security regulations define controls for secure handling of protected health information in electronic format. The language selected for inclusion in SB 144 – “The application and technology used to provide the health service meet all standards required by state and federal laws governing the privacy and security of protected health information” – was carefully considered over a period of several months. It is inclusive of all existing regulations, including HIPAA and the Oregon Consumer ID Theft Protection Act (ORS 14 646A.600-628), as well as any additions that might come in the future, and is technology neutral.
Telemedicine is an exciting delivery system that can help Oregon, and the nation, meet the health care needs of our populations. TAO is committed to working with all interested parties to ensure that we move forward to develop the very best telemedicine system in Oregon.
The Telehealth Alliance of Oregon (TAO) is a statewide membership organization focused on education and policy pertaining to the use and implementation of telehealth in Oregon. TAO is an information resource for payers, providers, hospitals, clinic, and policy makers about the benefits of telehealth and the delivery of health care services in an effort to increase access as well as achieve the goals of the Triple Aim: improving patient care; improving the health of populations; and reducing the per capita cost of healthcare. You can contact Catherine Britain, Director at [email protected].
